Navigating the billing process for Applied Behavior Analysis(ABA) therapy is complex. One of the biggest challenges is staying on top of Current Procedural Terminology (CPT) codes, which determine how services are described, billed, and reimbursed.
In 2025, theAMA CPT code set introduced 420 total changes— 270 new codes, 112deletions, and 38 revisions. While the core ABA codes remain the same, payer policies, telehealth eligibility, and state-level coverage rules continue to evolve. This guide reviews the key ABA CPT codes, highlights recent updates, and provides practical billing tips to help your practice reduce denials and maximize reimbursement.
What are CPT Codes?
CPT codes are standardized billing codes maintained by the American Medical Association. They serve as a universal language between providers and insurers, ensuring claims are processed consistently.
For ABA therapy, CPT codes document assessments, direct treatment, protocol modification/supervision, group sessions, and family guidance. Accurate use of these codes is essential for facilitating accurate billing and timely reimbursement.
2025 ABA CPT Codes
Category I Codes (97151-97158)
These codes represent established and recognized ABA services, such as assessments, individual and group interventions, and family-based interventions. Notably, codes 97155-97157 have been updated to allow for telehealth billing. These codes are typically billed in 15-minute units, but confirm as each payer can be different.
97151 | Behavior Identification Assessment: Used by a BCBA or qualified provider to conduct a comprehensive evaluation, including direct (face-to-face) assessment, indirect work (data analysis, scoring, report writing), and formulation of a treatment plan. Often referred to as “report writing.” Telehealth delivery is permissible in many payer policies, and the code is typically capped at 8 units (2 hours) per day, though limits can vary by insurer and state.
97152 | Behavior Identification Assessment: Support assessment performed by a technician under qualified healthcare professional supervision. Commonly billed alongside 97151.
97153 | Adaptive Behavior Treatment Protocol: Face-to-face adaptive behavior treatment sessions delivered by a technician under supervision of a qualified healthcare professional after the initial evaluation.
97154 | Group Adaptive Behavior Treatment Protocol: When a technician delivers adaptive behavior treatment in a group setting to build social and communication skills among clients. Sessions are typically face-to-face and focus on peer interaction and skill generalization.
97155 | Adaptive Behavior Treatment with Protocol Modification: Used when a BCBA or qualified provider directly modifies a client’s treatment protocol during a face-to-face session, often while directing a technician. Billing pure supervision (without client present) is not permitted, and telehealth reimbursement depends on payer policy.
97156 | Family Adaptive Behavior Treatment Guidance: Family therapy aimed at teaching skills to support the client’s treatment plan at home (with or without the patient present). Some payers now permit telehealth billing for family guidance codes such as 97156, but coverage varies widely by insurer and state. Always review payer contracts and provider manuals before submitting claims.
97157 | Multiple Family Group Adaptive Behavior Treatment Guidance: In-person sessions with multiple groups of guardians or caregivers (without the patient present), encouraging sharing experiences and strategies in a supportive environment. Some insurers cover via telehealth, but check eligibility in advance.
97158 | Group Adaptive Behavior Treatment Protocol: Used when a BCBA (not a technician) directly conducts group adaptive behavior treatment sessions for clients with similar goals. The BCBA leads the session, provides active treatment (not supervision), and targets social, communication, or adaptive skill development through peer interaction.
Category III Codes (0362T, 0373T, 0770T)
These temporary codes capture emerging or highly specialized ABA services, including the assessment of adaptive behavior and technician-delivered treatment with protocol modifications.
0362T | Exposure Behavioral Follow-Up Assessment: Evaluation for clients exhibiting destructive behaviors, requiring multiple technicians (at least two) working directly with the patient (face-to-face). Supervised on-site by a qualified healthcare professional in a tailored environment.
0373T | Adaptive Behavior Treatment with Protocol Modification: Used when two or more technicians deliver adaptive behavior treatment for a client with severe or destructive behaviors, under the on-site supervision of a BCBA or other qualified healthcare professional. The supervising provider must be physically available and directing care but cannot bill separately for supervision during this service.
0770T | Virtual Reality Adjunct Code: A newer Category III code for reporting the use of VR during therapy, including adaptive behavior interventions. Adoption varies widely and not all payers accept it.
⚠️ Important: Not all insurers reimburse Category III codes. Always confirm coverage with the payer before delivering services.
Telehealth CPT Code Considerations in 2025
Video visits remain the most widely accepted modality for telehealth.
Audio-only telehealth is generally not reimbursed for ABA CPT codes.
Payer adoption of telehealth for 97156 and 97157 has expanded since the pandemic, but coverage can differ from state to state.
Some Medicaid programs are revising telehealth rules for ABA. For example, New Hampshire has proposed altering coverage of code 97155 starting July 2025. Always verify fee schedules and requirements with your payer before providing services.
Tips to Avoid ABA Claim Rejections/Denials
Even when using the correct CPT coding, ABA practices often face insurance billing rejections. Every rejected claim eats up valuable time and resources, forcing your team to rework documentation, resubmit claims, and chase delayed reimbursements. This is especially frustrating when being rejected for issues that could have been prevented up front.
Here are proactive steps to boost your first-pass acceptance rate and keep days in AR low:
Verify coverage and authorizations early - Confirm eligibility, prior authorizations, and service limits before treatment begins. Many denials stem from skipped or expired approvals.
Adhere to the “8-minute midpoint” threshold for timed services - For CPT codes billed in 15-minute units, sessions lasting fewer than 8 minutes typically do not qualify for billing that unit. Claims that do not reach this minimum threshold are common causes of denials. (According to ABA Coding Coalition guidance and payer rounding policies, 8–22 minutes is often the window for one full unit.)
Use correct modifiers - Telehealth sessions, technician-delivered services, or supervision scenarios often require payer-specific modifiers. Missing or incorrect modifiers are a top denial cause.
Check payer rules on concurrent billing - Some insurers restrict certain codes from being billed together. Cross-check before submission to prevent automatic rejections or unethical billing.
Keep documentation tight and consistent - Align session notes, treatment plans, and CPT coding. If payers see gaps, they’ll reject the claim.
Monitor timely filing deadlines and resubmission windows - Payers may allow 60–180 days for initial submissions, but Medicaid and commercial plans vary. Late claims are rarely paid.
Leverage your practice management system (PMS) - Automated billing tools flag missing data and scrub claims, integrating scheduling and session notes to reduce manual errors that cause denials.
Cross-check code combinations and bundling rules – Some payers will automatically deny claims if “mutually exclusive” ABA codes are submitted together (e.g., 97151 billed on the same date as 97152). Always review your payer’s provider manual for bundling edits and modifier rules before submission.
Submit claims promptly and track resubmission windows – Most commercial payers allow 60–180 days from the date of service to file a claim, but some Medicaid programs enforce shorter filing limits (sometimes 90 days or less). Missed deadlines are rarely appealable, so building reminders into your PMS is critical.
Stay current on payer updates and state Medicaid bulletins – ABA coverage rules shift frequently. For example, Washington State Medicaid issued a new ABA services billing guide effective Feb 2025, and New Hampshire Medicaid has proposed coverage changes to 97155 for July 2025. Monitoring payer updates ensures you don’t miss code, telehealth, or reimbursement policy changes.
The Role of AlohaABA in Accurate ABA Billing
While CPT mastery is critical, having the right technology can reduce human error, save valuable time, and help your team get paid faster.
Integrated scheduling + billing - Session data flows automatically from appointments into your billing queue, reducing manual data entry and coding errors.
Clean claims, from the start - Built-in checks flag missing fields, required billing rules, and authorization issues before submission, helping prevent rejections and keeping your acceptance rate high.
Transparent reporting - Real-time dashboards track days in AR, claim tracking, and payer performance so you can identify issues before they affect cash flow.
For practices ready to offload the complexity of billing entirely, AlohaABA’s Managed Billing services provide full end-to-end revenue management handled by real human billing experts, not AI bots. Every claim is reviewed with care, accuracy, and accountability so you can focus on client care, not collections.
Final Takeaway
The 2025 CPT code updates reinforce how fast the ABA billing landscape can shift. Staying current with codes, payer policies, and telehealth rules is essential for protecting revenue.
By combining CPT knowledge with the right practice management tools and support from human billing experts when needed, ABA providers can reduce denials, improve cash flow, and focus more on client care.
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